Health‐related lifestyle behaviors predict changes in cognitive status in older adults: A latent transition analysis of data from the Mexican Healthy Aging Study 2012‐2018

Abstract Background Health behaviors, such as exercise, smoking, and alcohol consumption, are potentially modifiable risk factors for cognitive impairment and dementia. The effect of these behaviors on cognitive function is important to examine in Mexico, which faces a rapidly aging population. Method Data came from the 2012, 2015, and 2018 waves of the Mexican Health and Aging Study. The final sample included 8,112 participants aged 60 and older. We used latent transition analysis (LTA) to identify latent statuses of cognitive functioning using standardized scores for five cognitive tasks (orientation, visual scanning, verbal learning, delayed verbal recall, and verbal fluency). We evaluated associations between baseline lifestyle behaviors and transition probabilities for latent statuses of cognitive functioning across observation waves. Result We identified a three‐status model across the three waves with support for measurement and stationary invariance. Latent statuses were characterized by low (24% at baseline), average (55%), and high cognitive abilities (21%). With probabilities of .66, .78, and .90, respectively, individuals’ statuses tended to stay the same between time periods. The probabilities of an individual with these statuses transitioning to death were .15, .07, and .02, respectively. For individuals with a low cognition status, reporting exercising or doing hard physical work three or more times a week on average during the two years preceding baseline was associated with lower odds of transitioning to either death (OR = 0.551, p<.001) or a high cognition status (OR = 0.006, p<.001), in relation to staying in the same status. Similarly, alcohol use for this group was associated with decreased odds of transitioning to either death (OR = 0.74, p = .040) or a high cognition status (OR = 0.005, p<.001). Finally, for individuals with a low cognition status, reporting reading regularly was associated with increased odds of transitioning to average cognition status (OR = 1.44, p<.046), in relation to staying in the same status. Conclusion Findings suggest that individuals tended to stay in the same cognitive status over time and that reading regularly predicted favorable changes in cognition. LTA may be useful for identifying discreet statuses and subsequent transitions in older adults’ cognitive functioning as determined by performance on cognitive tasks.